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DONATION FORM

Click HERE for a printable version of our DONATION FORM.

Enclosed is my/our donation of $__________.
(Tax receipts and/or cards are mailed for gifts of $10.00 or more.)

___ Cheque payable to Variety the Children's Charity of Manitoba

OR

___ Charge my: Visa _____ MasterCard _____ American Express _____

Account #_________________________________________

Expiry Date ____________

Verification Code (found on back of card) ______________

FUND DESIGNATION:

General _____ Variety's Camp Brereton _____ Special Needs Program _____ Variety Heritage Adventure Park _____

I would like to dedicate this donation _____ NO

If YES please complete the following:

Card to be signed from:

_____________________________________________________


This gift is given in memory of:

_____________________________________________________


This gift is given in honour of / on behalf of:

_____________________________________________________

SEND ACKNOWLEDGEMENT CARD TO:

Name _______________________________________________________________

Address _______________________________________________________________

City _____________________________________

Postal Code ___________________

SEND TAX RECEIPT TO DONOR:

Name _______________________________________________________________

Address _______________________________________________________________

City _____________________________________

Postal Code ___________________

Phone Number _________________________

Cheques should be made payable to Variety the Children's Charity.

Donations may also be made by faxing the printable version of this form to 204.475.3198

Please mail your donation to Variety the Children's Charity, #2 - 1313 Border Street Winnipeg, Manitoba R3H 0X4

#2 - 1313 Border Street | Winnipeg, Manitoba R3H 0X4 | Phone 204.982.1050 | Fax 204.475.3198
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